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PubMed1976

Tooth fragments lodged in unexpected areas.

Broken, lost, swallowed, or aspirated teeth can be a hazard in dental and medical practice. Because of the magnitude of soft-tissue trauma associated with minor tooth fracture, the physician may be the first to see the child. Every attempt should be made to locate the missing tooth structure before the wound is closed. This can be accomplished through a detailed history of the accident, careful examination, and roentgenograms, if necessary. Three cases are reported in which tooth fragments were imbedded in wounds.

Accidents, Home↗
PubMed2005

Traumatic fracture of anterior teeth in 12-year old Nigerian children.

INTRODUCTION: The WHO has chosen the 12year-old age group as one of the sentinel groups for the monitoring of oral health of the population. Tooth loss in 12year olds is significant because the dentition is still developing and any disruption will affect the development of the arch, occlusion and patient's aesthetic. MATERIALS AND METHODS: 1600 12-year-old secondary school pupils were examined in six local government areas of Lagos State. The WHO pathfinder methodology was used. RESULTS: In this study, more boys 86 (10.8%) had various degrees of trauma to their anterior teeth compared to 71 girls (8.9%)(M:F Ratio is 1.2:1). The overall prevalence of tooth fractures was 9.8%. The most frequent injury was class II fractures (52.2%) and there were more fractures to the maxillary teeth than mandibular teeth, the difference is statistically significant p<0.0 1. The central incisors were the teeth most frequently fractured in both sexes. DISCUSSION: The prevalence of fractured anterior teeth in this study, even though is lower than earlier studies can be said to be high for this age group because the greatest number of injuries occur at about 14 years of age. Maxillary incisors in this study have a higher prevalence of fractures. A significant finding in this study is that none of the students with fractured anterior teeth have received dental treatment for the fractures CONCLUSION: There is a high prevalence of fractured anterior teeth in 12year- olds and this problem has not received the necessary attention of the dental profession. Oral health education with the provision of school dental services is recommended as means of solving this problem.

Accidental Falls↗
PubMed1994

Etiology of cracked teeth: a review and proposal.

Factors in the etiology of the cracked or fractured tooth can be generally divided into three categories: tooth strength, magnitude of applied force, and control of applied force. Dental caries, restorations and endodontic procedures appear to play a major part in the etiology of most cracked or fractured teeth though sound teeth frequently are cracked or fractured. Tentative evidence indicates that females, who can apply less force, may crack more teeth than do males. Control of occlusal forces applied may be an overlooked factor. Drugs affecting proprioception and other sensory receptors modulating force and reflex should be evaluated as possible contributors to the etiology of cracked or fractured teeth.

Animals↗
PubMed1976

The cracked-tooth syndrome and fractured posterior cusp.

1. Even from such a small sample as that reported in this study, it is evident that the fractured cusp and cracked-tooth syndrome are common problems. The large number of fractured cusps compared to the cracked-tooth syndrome suggests that some of the cases of fractured cusp could have been diagnosed earlier. 2. It is most important that dentists be aware of the cracked-tooth syndrome in order to relieve the patient's discomfort, prevent the possible eventual loss of the pulp or tooth, and avoid unnecessary and possibly damaging treatment for misdiagnosed facial pain. 3. Conservation of tooth structure in restorative procedures is most necessary in order to prevent the cracked-tooth syndrome or fractured posterior cusp.

Cracked Tooth Syndrome↗
PubMed1984

Fracture properties of human enamel and dentin in an aqueous environment.

SEM fractography and work-of-fracture techniques were used to investigate the fracture properties of human enamel and dentin as a function of the temperature of an aqueous environment. Both enamel and dentin were found to be anisotropic with respect to mechanical failure but were found to have little variation in fracture properties with respect to temperatures from 0 degree to 70 degrees C. Fractographs of a naturally fractured tooth were consistent with experimental findings. The results of this research indicate that natural fracturing of teeth probably cannot be explained on the basis of a reduced work of fracture resulting from chewing hot or cold foods. It was also shown that if dentin surfaces can be kept below 100 degrees C during cavity preparation, the restored tooth will not be weakened by an irreversible reduction of its work of fracture.

Adolescent↗
PubMed1991

Dynamic resistance of teeth: technical considerations and applications of an experimental device.

Tooth fracture by impact is the most common cause of fracture in human incisors. We have designed an experimental system to measure the dynamic fracture force of teeth in vitro, and initial results obtained from a sample of healthy, recently removed human incisors are reported. The method was reproducible and reliable, and the results provide a baseline for studies evaluating the effect of endodontic procedures on the dynamic fracture force of teeth.

Dental Stress Analysis↗
PubMed1999

Facial injuries in skiing. A retrospective study of 549 cases.

In the last 2 decades, reports of skiing injuries have shown an increasing number of skiers with severe trauma. This article provides an account of a retrospective study of 549 patients with 1155 facial injuries sustained while skiing who received treatment at the Department of Oral and Maxillofacial Surgery at the University Hospital in Innsbruck, Austria between 1991 and 1996. The study was based on a questionnaire answered by the patients and on case report forms. Most of the patients were male (65.2%) and were aged between 3 and 81 years (average 28.4 years). A simple fall while skiing was the main type of accident (45.9%), followed by collisions with other people (23.5%). Injuries were classified into 1 of 3 groups: (i) lesions of the soft tissue (32.2% of all injuries); (ii) dentoalveolar traumas (24.3%); and (iii) fractures of facial bones (43.5%). Lacerations and haematomas were the most frequent lesions in patients with injuries to the soft tissues. The group of patients with dentoalveolar trauma mainly presented with fractures of tooth crowns. Fractures involving the mandible and the zygomatic bone were predominant in patients in the third group. Concomitant injuries mainly included injuries to the brain and skull fractures. Treatment was ambulatory, or by admission and surgery. We did not observe an increase in the number of skiing accidents causing facial injury in the last 5 years. Facial injuries represented 4% of all skiing injuries, a lower proportion than in other sports.

Accidental Falls↗
PubMed2006

Multiple dental fractures following tongue barbell placement: a case report.

The number of adolescents and young adults undergoing intra-oral piercing, is increasing worldwide. There have been several case reports documenting oral and systemic complications of this practice. These include damage to the dentition, gingivae, infection, speech impediments and nerve damage. The case presented here draws attention to the possibility of multiple tooth fracture as a result of trauma incurred from a barbell inserted into the tongue.

Adolescent↗
PubMed2005

Placement and replacement of restorations by selected practitioners.

BACKGROUND: There are few Australian data on the reasons for placement and replacement of restorations, and the extent to which these are carried out in general practice. METHODS: A survey was carried out of approximately 100 consecutive restorations placed by each of 28 general dental practitioners. The data were coded and statistically analyzed for various associations. RESULTS: Resin composite was used twice as frequently as amalgam as a restorative material, and nearly four times as often as glass-ionomer cement. Secondary caries was the principal reason for replacing restorations, affecting predominantly amalgam restorations in Class I and Class V cavities. Teeth restored with amalgam fractured nearly twice as often as teeth restored with resin composite. The average ages of amalgam, resin composite and glass-ionomers at replacement were 13.6, 7.1 and 5.7 years respectively. CONCLUSIONS: Amalgam has the longest clinical service life, but is associated with more tooth fracture. Secondary caries is the main reason for replacing restorations. The anti-cariogenic effect of glass-ionomer cement is equivocal.

Adolescent↗
PubMedDate not supplied

Fracture resistance of teeth with Class 2 silver amalgam, posterior composite, and glass cermet restorations.

This article reports the fracture resistance of maxillary premolars in which ideal class 2 mesio-occlusal or disto-occlusal cavities were prepared and restored with silver amalgam, posterior composite, and glass cermet. Sound teeth and teeth with prepared but unrestored cavities were also studied for comparison. Dentin-bonded posterior composite resin produced the best tooth fracture resistance, followed by glass cermet, intact teeth, silver amalgam, and unrestored-prepared teeth, in that order.

Composite Resins↗
PubMed2003

The effect of amalgam bonding on the stiffness of teeth weakened by cavity preparation.

OBJECTIVE: The objective of this study is to evaluate the effect of amalgam bonding on the stiffness of teeth weakened by cavity preparation. METHODS: Strain gages were bonded to maxillary premolars. The rigidity was tested by applying a load to a sequence of sound, prepared and restored teeth as follows: sound tooth, MOD preparation, amalgam restoration, amalgam removed recovering the MOD preparation, bonded amalgam restoration, bonded amalgam removed recovering the MOD preparation, bonded composite restoration. The relative stiffness (RS) and relative deformation (RD) of each condition for each cusp to that of the sound tooth was determined. RESULTS: The premolar cusps were deformed 1.80, 2.14, and 2.32 times more than the cusps of the sound tooth for the three succeeding MOD preparations. For these three preparations, the stiffness of the premolar cusps was 0.58, 0.48, and 0.46 relative to a stiffness of 1.00 for the sound tooth. The deformation was 1.77, 1.27, and 1.16 for the non-bonded amalgam, the bonded amalgam, and the bonded composite, respectively, corresponding to a mean RS of 0.59, 0.80, and 0.88. The calculated mean stiffness parameter C (standard deviation) was 2.6% (6.9) for the amalgam restoration, 62.5% (12.8) for the bonded amalgam restoration, and 77.8% (15.8) for the bonded composite restoration. The stiffness parameter C measured the extent to which the procedure returned the stiffness of the restored tooth to the original stiffness of the intact tooth (100%). SIGNIFICANCE: Cavity preparation reduced the stiffness and weakened the tooth. Restoring the prepared tooth with unbonded amalgam did not restore the lost tooth stiffness. Restoring the prepared tooth with bonded amalgam or with bonded composite recovered a significant portion of the lost tooth stiffness. It was concluded that bonding amalgam to tooth structure could partly restore the strength and rigidity lost by the cavity preparation. This might lead to a reduction in cuspal flexure and the incidence of tooth fracture due to fatigue.

Analysis of Variance↗
PubMed1984

The fracture toughness of tooth coloured restorative materials.

A fracture mechanics approach has been used to quantify the failure of tooth coloured restorative materials which are subjected to tensile forces. The materials examined included silicates, glass ionomers, composites (both chemically and photo-initiated) and bonding resins for composites. The parameter chosen was the plane strain critical stress intensification factor, KIC. Silicate and glass ionomer are both brittle and have values for KIC inferior to those of composites. Composites have fracture toughnesses in a range from marginally higher than that of the bonding resin to almost three times that figure. The reason for this is discussed in terms of the dispersion toughening theories.

Chemical Phenomena↗
PubMed1990

[The role of x-ray films in diagnosis in operative dentistry].

In operative dentistry x-ray films play an important part as a diagnostic procedure. Image quality depends on factors such as exposure and projection but also on optimum processing of the x-ray film. Of particular importance among the exposure-related factors are such features as variable voltage, short exposure time and narrow focussing. According to the new regulations in Germany x-rays may be used if this is indicated for medical reasons in dentistry. This condition is given far more frequently than x-rays are performed in the dental office. In the diagnosis of caries individual bitewing radiographs, if indicated, should always be preferred over panoramic radiographs. In pulp diseases radiographs may aid in detecting chronic pulpitis and in differential diagnosis with apical periodontitis. Both for diagnosis and documentation on intraoral films, tooth fractures are best imaged using two different projections. Radiovisiography facilitates radiographic diagnosis by employing a simple technique and operating with considerably lower doses.

Dental Caries↗
PubMed2003

Lack of tooth eruption following maxillary fracture: case report.

Aberrant tooth development following facial fractures is unusual. It is commonly reported that tooth buds involved in the line of a mandibular fracture will continue to develop normally and erupt sequentially. Few cases have been cited regarding developing teeth in the line of maxillary fractures. In the case reported, the normal growth and position of a maxillary third molar can be seen to be retarded at the position of a maxillary fracture, sustained by a child in the mixed dentition phase of dental development.

Accidental Falls↗
PubMedDate not supplied

Review of bonded amalgam restorations, and assessment in a general practice over five years.

This study reviewed the literature on bonded amalgam restorations and assessed the failure, marginal fracture and marginal staining behavior of 366 Permite C amalgam restorations lined with five dentin bonding resins (Scotchbond 2, Panavia Ex, Amalgambond, Amalgambond Plus, Geristore) and a polyamide cavity varnish (Barrier). The restorations were placed in the posterior permanent teeth of 190 adult patients and examined at intervals over periods of up to five years. There were five restoration failures (1.4%), usually from tooth fracture, involving Class II preparations in molar teeth. No instances of persistent pulpal sensitivity or recurrent caries were reported. The marginal deterioration of the restorations was assessed indirectly using photographs for comparison with two standard sets of enlarged color transparencies. Most of the marginal fracture and marginal staining scores were low, with little difference between the six lining materials at any period.

Adult↗
PubMed2000

Diagnostic imaging with newly developed ortho cubic super-high resolution computed tomography (Ortho-CT).

OBJECTIVE: Ortho cubic super-high resolution computed tomography (Ortho-CT), which we have developed, is characterized by the small size of the unit and the ability to produce 3-dimensional images of high resolution with low-radiation doses. The purpose of this study was to investigate the clinical usefulness of Ortho-CT for the diagnosis of diseases in the oral and maxillofacial region. STUDY DESIGN: Ortho-CT has been used for the imaging diagnosis of a radicular cyst of the upper first molar, mesiodense, tooth fractures in the upper anterior region, a fracture of the condylar process, or presurgical evaluation for a dental implant. The usefulness of 3-dimensional images obtained by Ortho-CT was investigated in this study. RESULTS: Ortho-CT produced images of high resolution, enabling identification of the extent of the lesions and the fracture line, the condition of the impacted tooth, and the relationship with the maxillary sinus, mandibular canal, and adjacent teeth. CONCLUSION: Because Ortho-CT can take high-resolution 3-dimensional images at any tomographic layer with only 1 exposure, it is useful for the diagnosis of diseases in the oral and maxillofacial region.

Adult↗